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1.
Pan Afr Med J ; 35(Suppl 2): 145, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193960

RESUMEN

Introduction: available evidence suggests that children infected with COVID-19 tend to have a less severe form of the disease. However, most of the studies that have established this largely emanate from outside sub-Saharan Africa. The pandemic nature of the infection makes it instructive to evaluate its pattern among children across different climes, including ours. This study was set out to describe the clinical characteristics of children with COVID-19 in Bauchi State, North-East Nigeria. Methods: this was a cross sectional study that involved 53 children between the ages of 0 and 18 years, who had RT-PCR confirmed COVID-19 infection between March and June 2020 in Bauchi State, Nigeria. Data on epidemiological and clinical characteristics was analysed using IBM SPSS Statistics V 21.® Relationship between categorical variables was established using the chi square test. The level of statistical significance was set at < 0.05, at a confidence interval (CI) of 95%. Results: the mean age was 12.63 ± 4.31 years with a slight preponderance of males (1.1: 1). Majority were asymptomatic (60.4%), while 32.1% and 7.5% had mild and moderate diseases respectively. The most common symptoms were cough (20.8%), fever (17%), and sneezing (15.1%). Five children (9.4%) complained of loss of taste while anosmia was documented in one child (1.9%). We observed a significant relationship between age category and the presence of symptoms. In fact, children younger than 10 years (pre-adolescents) were five times more likely to be symptomatic when compared to those above this age (p = 0.029, C I 1.08-21.56). Conclusion: our findings have shown a mild pattern of disease and good outcome among infected children. However, we must be mindful of the higher vulnerability among younger children, especially those below 10 years.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Adolescente , Distribución por Edad , Infecciones Asintomáticas/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Nigeria/epidemiología , Distribución por Sexo , Evaluación de Síntomas , Resultado del Tratamiento
2.
BMC Public Health ; 20(1): 1648, 2020 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-33148202

RESUMEN

BACKGROUND: Studies have shown that the outbreak of infectious diseases would result in mental health problems. Females are in greater risk for psychological problems than males. The present study investigated gender differences of depression and anxiety and explored associated factors during the COVID-19 epidemic among Chinese social media users. METHODS: We recruited 3088 participants through social media cross China. Participants completed sociodemographic and the COVID-19 epidemic related questions, the 2-item Patient Health Questionnaire (PHQ-2), and the 2-item Generalized Anxiety Disorder Scale (GAD-2), the Chinese version of the 10-item Connor-Davidson Resilience Scale. We applied Chi-square test and ANOVA for data description and linear regression analysis for exploring factors associated with depression and anxiety. RESULTS: Of 3063 participants eligible for analysis, the total prevalence of depression and anxiety was 14.14 and 13.25%. Females were experiencing more severe stress and anxiety symptoms, while males showed better resilience to stress. The severity of depression symptoms would decrease with the increase of age resilience, and it would increase if being unemployed, feeling less adapted, being more stressed. The severity of anxiety symptoms would decrease with higher education and better resilience, and it would increase if being female, spending over 60 min on COVID-19 related information, less adapted, and being more stressed. CONCLUSION: The findings show the increased prevalence of depression and anxiety in Chinese population during the COVID-19 epidemic, and females are experiencing more severe anxiety symptoms than males. As social media is the current main resource of information related to COVID-19, interventions should be implemented to help users to limit the time they spend on social media and to get key information related to the epidemic from authoritative and authentic resource to avoid infodemic and prevent mental health problems.


Asunto(s)
Ansiedad/epidemiología , Infecciones por Coronavirus/epidemiología , Depresión/epidemiología , Brotes de Enfermedades , Disparidades en el Estado de Salud , Neumonía Viral/epidemiología , Medios de Comunicación Sociales/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Cuestionario de Salud del Paciente , Prevalencia , Distribución por Sexo , Adulto Joven
3.
Biomed Pharmacother ; 131: 110748, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33152916

RESUMEN

The severe form of COVID-19 has significant sex disparities, with high fatalities commonly reported among males than females. The incidence of COVID-19 has also been higher in males compared with their female counterparts. This trend could be attributed to a better responsive and robust immune system in females. Cytokine storm is one of the pathophysiological features of severe COVID-19, and it occurs as a result of over-activation of immune cells leading to severe inflammation and tissue damage. Nevertheless, it is well modulated in females compared to their male counterparts. Severe inflammation in males is reported to facilitate progression of mild to severe COVID-19. The sex hormones, estrogens and androgens which exist in varying functional levels respectively in females and males are cited as the underlying cause for the differential immune response to COVID-19. Evidence abounds that estrogen modulate the immune system to protect females from severe inflammation and for that matter severe COVID-19. On the contrary, androgen has been implicated in over-activation of immune cells, cytokine storm and the attendant severe inflammation, which perhaps predispose males to severe COVID-19. In this review efforts are made to expand understanding and explain the possible roles of the immune system, the sex hormones and the angiotensin-converting enzyme (ACE) systems in male bias to severe COVID-19. Also, this review explores possible therapeutic avenues including androgen deprivation therapy (ADT), estrogen-based therapy, and ACE inhibitors for consideration in the fight against COVID-19.


Asunto(s)
Betacoronavirus/fisiología , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antagonistas de Andrógenos/farmacología , Antagonistas de Andrógenos/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Animales , Niño , Preescolar , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/terapia , Susceptibilidad a Enfermedades , Femenino , Hormonas Esteroides Gonadales/fisiología , Humanos , Inmunidad Innata , Lactante , Recién Nacido , Inflamación , Masculino , Ratones , Persona de Mediana Edad , Peptidil-Dipeptidasa A/fisiología , Neumonía Viral/complicaciones , Neumonía Viral/inmunología , Neumonía Viral/terapia , Neoplasias de la Próstata/complicaciones , Neoplasias de la Próstata/tratamiento farmacológico , Proteína Disulfuro Isomerasas/fisiología , Receptores de Superficie Celular/fisiología , Receptores Virales/fisiología , Distribución por Sexo , Fumar/efectos adversos , Adulto Joven
4.
Epidemiol Serv Saude ; 29(5): e2020644, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33175011

RESUMEN

OBJECTIVE: To describe the profile of deaths and the lethality of Severe Acute Respiratory Syndrome (SARS) due to COVID-19 in hospitalized children and adolescents in Brazil. METHODS: This was a cross-sectional study conducted with data from the SARS notification forms of children and adolescents (0 to 19 years old) with laboratory-confirmed COVID-19. Notifications with complete progression of SARS due to COVID-19 were included, up to the 38th Epidemiological Week of 2020. RESULTS: 6,989 hospitalizations were investigated, 661 died, resulting in 9.5% hospital lethality. Higher lethality rates were observed among children under 1 year of age (14.2%), female children and adolescents (9.7%), the indigenous (23.0%), and those living in rural areas (18.1 %), as well as in the Northeast (15.4%) and North (9.7%) regions of Brazil. CONCLUSION: Differences in hospital mortality were found according to sociodemographic characteristics and marked regional inequalities.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Mortalidad Hospitalaria , Neumonía Viral/mortalidad , Síndrome Respiratorio Agudo Grave/mortalidad , Adolescente , Distribución por Edad , Brasil/epidemiología , Niño , Preescolar , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Indios Sudamericanos/estadística & datos numéricos , Lactante , Recién Nacido , Masculino , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Características de la Residencia/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Síndrome Respiratorio Agudo Grave/etiología , Distribución por Sexo , Adulto Joven
5.
Maturitas ; 141: 59-62, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33036704

RESUMEN

OBJECTIVE: To examine mortality rates related to coronavirus disease 2019 (COVID-19) by gender among European countries. METHODS: PubMed, preprint medRxiv and bioRxiv repositories, and Google were searched for the terms COVID-19, mortality rates, gender, and Europe. Only Google provided a website with appropriate information. COVID-19 cases and deaths from European countries were extracted by gender from the Global Health 50/50 repository up to May 23, 2020. Extracted data included country, the total number of COVID-19 cases and the number of related deaths by gender. Random effects models with the inverse variance method were used for meta-analyses. Results are reported as death risk ratios (RRs). RESULTS: We identified information from 23 European countries that reported separately by gender mortality rates related to COVID-19. The sample comprised 484,919 men and 605,229 women positive for COVID-19. The mortality rate was significantly higher in men than in women (risk ratio = 1.60, 95 % confidence interval [CI] 1.53, 1.68). The trend was similar when countries reporting < 5000, or < 10,000 cases were excluded from the analysis (RR = 1.60, 95 % CI 1.52, 1.69 and RR = 1.68; CI 1.62, 1.76, respectively). CONCLUSION: In Europe, the new zoonotic coronavirus causes significantly more deaths in men than in women.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Pandemias , Neumonía Viral/mortalidad , Betacoronavirus , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Distribución por Sexo
6.
Arch Osteoporos ; 15(1): 165, 2020 10 20.
Artículo en Inglés | MEDLINE | ID: mdl-33079274

RESUMEN

In this study, the risk of fatality after hip fracture but not the risk of subsequent hip fractures was higher among men. INTRODUCTION: The purpose of this study was to analyze the risk factors for subsequent hip fractures and fatality after an initial hip fracture among Koreans older than 50 years of age using information in the national claims database. METHODS: Our study was conducted using data from the Korean National Health Insurance Service database from 2007 to 2016. A total of 16,915 Korean patients aged ≥ 50 years with a first hip fracture in 2012 were followed for 4 years. Data on fracture, comorbidity, and prescription variables were retrieved from the national registry. The Cox proportional hazards model was used to identify the risk factors affecting subsequent hip fractures and fatality after the initial hip fracture. RESULTS: A total of 952 patients had subsequent hip fractures, and 6793 patients died. The cumulative incidence rates were 1.3% after 1 year and 5.6% after 4 years. Old age, renal disease, dementia, and Parkinson's disease were associated with a higher risk of subsequent hip fractures. The fatality rate after the initial hip fracture was 1.6 times higher among men than among women. Certain risk factors for fatality, such as pneumonia after fracture, cerebrovascular disease, mild liver disease, renal disease, and malignancy, were more prevalent among men. CONCLUSION: During the study period, the risk of fatality after hip fracture but not the risk of subsequent hip fractures was higher among men. The gender difference in fatality might be explained by the larger burden of comorbid diseases among men.


Asunto(s)
Demencia/complicaciones , Fracturas de Cadera/mortalidad , Enfermedades Renales/complicaciones , Enfermedad de Parkinson/complicaciones , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Causas de Muerte , Comorbilidad , Femenino , Fracturas de Cadera/etnología , Fracturas de Cadera/etiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neumonía , Vigilancia de la Población , República de Corea/epidemiología , Factores de Riesgo , Distribución por Sexo , Factores Sexuales
7.
Arch Osteoporos ; 15(1): 152, 2020 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-33006016

RESUMEN

The incidence rate of hip fracture in Tottori Prefecture tended to increase until 2018 in men, but it did not increase after 2010 in women. By type of fracture, the incidence rate of femoral neck fractures also increased over time in men, but no other changes were observed from 2010. PURPOSE: The aims of this study were to determine the sex-, age-, and fracture-type-specific incidence rates of hip fractures in Tottori Prefecture between 2007 and 2018 and to compare the results with our past results to identify changes over time. METHODS: All hip fractures in people aged 35 years or older living in Tottori Prefecture were surveyed from 2007 to 2018 throughout the entire prefecture, and the age- and sex-specific incidence rates were calculated. The incidence rates from 1986 to 1988, 1992 to 1994, 1998 to 2000, and 2004 to 2006 previously reported were used for the analysis. RESULTS: In men, the age-adjusted number of patients adjusted by demographic structure based on the mean incidence rate for each 3-year period from 1986 to 2018 showed an increase in incidence over time compared with the incidence for 1986-1988 (p < 0.001). In women, the incidence rose over time compared with the incidence for 1986-1988 until 2004-2006 (p < 0.001), and no further increase was observed from 2010. The age-specific incidence rates of neck fracture in men were higher in 2010-2012 and 2016-2018 compared with 2004-2006 (p < 0.001), but those in women showed no increase with time. Those of trochanteric fracture did not change over time in either men or women. CONCLUSION: The hip fracture incidence rate in Tottori Prefecture, Japan, tended to increase until 2018 in men, but it did not increase after 2010 in women.


Asunto(s)
Fracturas del Cuello Femoral/epidemiología , Fracturas de Cadera/epidemiología , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Femenino , Fracturas del Cuello Femoral/etnología , Fracturas de Cadera/etnología , Humanos , Fracturas del Húmero/epidemiología , Incidencia , Japón/epidemiología , Masculino , Persona de Mediana Edad , Vigilancia de la Población/métodos , Distribución por Sexo
8.
Isr Med Assoc J ; 22(10): 618-622, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33070485

RESUMEN

BACKGROUND: Patients with severe chronic obstructive pulmonary disease (COPD) experience frequent exacerbations and need to be hospitalized, resulting in an economic and social burden. Although data exist regarding reasons of frequent hospitalizations, there is no data available about the impact on the length of stay (LOS). OBJECTIVES: To characterize the causes of prolonged hospitalizations in COPD patients. METHODS: A retrospective study was conducted of patients who were diagnosed and treated in the pulmonary department for severe COPD exacerbations. All patient demographic data and medical history were collected. Data regarding the disease severity were also collected (including Global Initiative for Obstructive Lung Disease [GOLD] criteria, pulmonologist follow-up, prior hospitalizations, and LOS). RESULTS: The study comprised 200 patients, average age 69.5 ± 10.8 years, 61% males. Of these patients, 89 (45%) were hospitalized for up to 4 days, 111 (55%) for 5 days or more, and 34 (17%) for more than 7 days. Single patients had longer LOS compared with married patients (48% vs. 34%, P = 0.044). Multivariate analysis showed that the number of prior hospital admissions in the last year was a predictor of LOS (P = 0.038, odds ratio [OR] = 0.807, 95% confidence interval [95%CI] = 0.659-0.988), as well as the use of non-invasive respiratory support by bilevel positive airway pressure (BiPAP) during the hospitalization (P = 0.024, OR = 4.662, 95%CI = 1.229-17.681). CONCLUSIONS: Fewer previous hospitalizations due to COPD exacerbations and the need for non-invasive respiratory support by BiPAP were found as predictors of longer LOS.


Asunto(s)
Progresión de la Enfermedad , Hospitalización/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Respiración con Presión Positiva/métodos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/terapia , Distribución por Edad , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Distribución de Chi-Cuadrado , Estudios de Cohortes , Bases de Datos Factuales , Femenino , Mortalidad Hospitalaria , Humanos , Incidencia , Israel , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , Análisis de Supervivencia
9.
Ann Pharm Fr ; 78(6): 459-463, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33038309

RESUMEN

OBJECTIVES: COVID-19 outbreak can impact mental health including health care workers. The aim of this study was to assess the psychological impact of COVID-19 in French community pharmacists. MATERIAL AND METHODS: We carried out a postal-based survey to assess the psychological impact of COVID-19 in French owner community pharmacists based on three validated self-report questionnaires: Perceived Stress scale, Impact of Event Scale-revised and Maslach Burnout Inventory. RESULTS: The sample consists of 135 community pharmacists. Twenty-three pharmacists reported significant post-traumatic stress symptoms (17%). High burnout symptoms were found in 33 (25%), 46 (34.9%) and 4 (3%) participants. Females scored higher than males for all questionnaires (P=0.01). CONCLUSIONS: This study is the first study which showed the psychological impact of COVID-19 in community pharmacists. Based on validated self-report questionnaires, up to 35% of pharmacists reported psychological disturbances. Interventions to promote psychological well-being of healthcare workers need to be developing.


Asunto(s)
Betacoronavirus , Agotamiento Profesional/etiología , Infecciones por Coronavirus/psicología , Estrés Laboral/etiología , Farmacéuticos/psicología , Neumonía Viral/psicología , Trastornos por Estrés Postraumático/etiología , Estrés Psicológico/etiología , Adulto , Anciano , Agotamiento Profesional/epidemiología , Servicios Comunitarios de Farmacia , Infecciones por Coronavirus/epidemiología , Despersonalización/epidemiología , Despersonalización/etiología , Emociones , Femenino , Francia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Estrés Laboral/epidemiología , Estrés Laboral/psicología , Pandemias , Neumonía Viral/epidemiología , Autoinforme , Índice de Severidad de la Enfermedad , Distribución por Sexo , Trastornos por Estrés Postraumático/epidemiología , Estrés Psicológico/epidemiología , Encuestas y Cuestionarios
10.
Medwave ; 20(8): e8031, 2020 Sep 25.
Artículo en Español | MEDLINE | ID: mdl-33017383

RESUMEN

Objective: To compare excess mortality by district quintiles according to the Human Development Index (HDI) in Metropolitan Lima, the capital of Peru, and analyze the socioeconomic factors associated with excess mortality within the context of COVID-19. Methods: Retrospective cross-sectional analysis of the mortality records from non-violent causes registered in the National Death Information System in the 50 districts of Metropolitan Lima of the first 24 weeks of the years 2019 and 2020. Descriptive analysis was performed using contingency tables and time series graphs by sex, age group, and quintile of the district of residence according to the HDI. Negative binomial regression analysis was performed to identify possible explanatory factors for excess mortality. Results: An excess of 20 093 non-violent deaths and 2,979 confirmed deaths from COVID-19 were registered in Metropolitan Lima during the study period. The increase was observed primarily in men and adults aged 60 and over. Residents in the districts belonging to the fifth quintile, according to HDI, presented, in most cases, the lowest rates. Multivariate analysis revealed that a higher HDI level (p = 0.009) and a higher proportion of inhabitants living in extreme poverty (p = 0.014) decreased the excess mortality. Conclusion: Excess of non-violent deaths in Metropolitan Lima is higher in the quintiles with the lowest HDI, in men, and the age group from 60 to more years of age. The study of social and economic health determinants in Peru is crucial for the design of measures to be taken by the government against the COVID-19 pandemic.


Asunto(s)
Causas de Muerte , Infecciones por Coronavirus/epidemiología , Mortalidad/tendencias , Neumonía Viral/epidemiología , Adolescente , Adulto , Distribución por Edad , Niño , Preescolar , Infecciones por Coronavirus/mortalidad , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Pandemias , Perú/epidemiología , Neumonía Viral/mortalidad , Pobreza , Estudios Retrospectivos , Distribución por Sexo , Factores Socioeconómicos , Adulto Joven
11.
Ital J Pediatr ; 46(1): 146, 2020 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-33023616

RESUMEN

BACKGROUND: There is ample evidence that COVID-19 is significantly less severe in children than in adults and asthma and allergy, the most common chronic disorders in children, are not included in the top 10 comorbidities related to COVID-19 fatalities. Nevertheless, concerns about asthma and allergy are still high.. In order to evaluate the impact of paediatric COVID-19 among Italian paediatricians, we sent a 20-questions anonymous internet-based survey to 250 Italian paediatricians with particular address to allergic symptoms and those affecting the upper airways. METHODS: The questionnaire was conceived and pretested in April 2020, by a working group of experts of the Italian Paediatric Society for Allergy and Immunology (SIAIP), and structured into different sections of 20 categorized and multiple choice questions. The first part included questions about epidemiological data follows by a second part assessing the way to manage a suspected COVID-19 infection and personal experiences about that. The third part concerned questions about patients' clinical characteristics and clinical manifestations. The survey was emailed once between April and mid-May 2020. RESULTS: A total 99 participants had participated in our survey and provided responses to our electronic questionnaire. The distribution of patients reported per month varies significantly according to the geographical area (P = 0.02). Data confirmed that in the North part of Italy the rate of patients referred is higher than in the rest of Italy. Almost all respondents (98%) reported caring for up to a maximum of 10 infected children and the last 2% more than twenty. Among these patients, according to the 75% of responders, a maximum rate of 20% were affected by allergic rhino-conjunctivitis and in particular in the North of Italy while in the Centre and in the South there was a higher incidence (P = 0.09). Almost the same applies for asthma, 83% of responders declared that up to a maximum of 20% of affected children were asthmatic, from 20 to 40% for the 13,5% of responders and from 40 to 60% for the last 3,5%. As for the allergic conjunctivitis also for asthma, we found a higher incidence in the Centre and in South than in the North (P = 0.03). CONCLUSIONS: This study is the first to provide a comprehensive review of COVID-19 knowledge and impact among paediatricians in Italy about allergic asthma and upper airway involvement. From our point of view, it provides important information clearly useful for improving a good practice.


Asunto(s)
Conjuntivitis Alérgica/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Rinitis Alérgica/epidemiología , Encuestas y Cuestionarios , Adolescente , Distribución por Edad , Causalidad , Niño , Conjuntivitis Alérgica/diagnóstico , Infecciones por Coronavirus/prevención & control , Estudios Transversales , Femenino , Humanos , Incidencia , Italia/epidemiología , Masculino , Pandemias/prevención & control , Pediatras/estadística & datos numéricos , Pediatría/normas , Neumonía Viral/prevención & control , Rinitis Alérgica/diagnóstico , Medición de Riesgo , Distribución por Sexo , Sociedades Médicas
12.
Open Heart ; 7(2)2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33020258

RESUMEN

BACKGROUND: Cardiac involvement with COVID-19 is increasingly being recognised. Clinical characteristics and outcomes of patients with COVID-19 complicated by secondary Takotsubo cardiomyopathy (TC) is poorly understood. METHODS: This retrospective case series was conducted between March and April 2020 at four hospitals of Steward Health Care Network of Massachusetts, USA. Seven patients out of 169 who had echocardiogram were identified to have features of TC. Demographic, clinical, laboratory, management and outcome were gathered from their electronic medical records. We also reviewed all the published cases of COVID-19 and TC in the literature to recognise their common clinical characteristics, risk factors and outcomes. RESULTS: In our series of seven patients, three typical, two inverted, one biventricular and one global TC were recognised. Three were females and four were males. The mean age was 71±11 years. In-hospital death was observed in 57% of patients. Patients who belonged to the high-risk group and had high-risk echocardiographic features in our series had a 100% mortality rate. CONCLUSIONS: COVID-19 complicated by TC has a high mortality rate. Early identification of patients with COVID-19 who are at higher risk for developing secondary TC is important for the prevention of complications, and thus improved outcomes.


Asunto(s)
Causas de Muerte , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades/estadística & datos numéricos , Neumonía Viral/epidemiología , Cardiomiopatía de Takotsubo/diagnóstico por imagen , Cardiomiopatía de Takotsubo/epidemiología , Distribución por Edad , Anciano , Estudios de Cohortes , Comorbilidad , Infecciones por Coronavirus/diagnóstico , Ecocardiografía/métodos , Electrocardiografía/métodos , Femenino , Corazón Auxiliar , Mortalidad Hospitalaria/tendencias , Humanos , Masculino , Massachusetts , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico , Prevalencia , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , Cardiomiopatía de Takotsubo/terapia
13.
Cancer Control ; 27(1): 1073274820960457, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33043705

RESUMEN

In this retrospective study we analyze and compare clinical characteristics and outcomes of patients with and without cancer history who were infected with novel coronavirus disease 19 (COVID-19). Medical records were reviewed and a comparative analysis of 53 cancer and 135 non-cancer patients with COVID-19 were summarized. Results: The median age for COVID-19 patients with and without cancer was 71.5 and 61.6 years, respectively. Patients aged 60 years and above were 86.8% and 60.7% in cancer and non-cancer groups, respectively. A high proportion of cases were seen in African Americans 73.6% (with cancer) and 75.6% (without cancer) followed by Hispanic patients. Male and female patients had a high percentage of prostate (39.3%) and breast (32%) cancer respectively. Prostate cancer (18.9%) and myeloma (11.3%) were common among solid and hematological cancers respectively. Hypertension and smoking were prevalent among cancer (83% and 41.5%) compared to non-cancer (67.4% and 9.6%) patients. The common symptoms in cancer patients were dyspnea (64.2%) followed by fever and cough (50.9%) compared to fever (68.1%) and cough (66.7%) in non-cancer patients. Cancer patients had higher levels of lactic acidosis, C-reactive protein, lactate dehydrogenase, and alkaline phosphatase than non-cancer patients (p < 0.05). Conclusions: Rapid clinical deterioration was seen in cancer patients who were aged 60 years and above. Higher mortality was seen in this subgroup, especially when they had associated hypertension and elevated levels of CRP and LDH.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neoplasias/epidemiología , Pandemias , Neumonía Viral/epidemiología , Anciano , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Distribución por Sexo , Factores Sexuales , Tasa de Supervivencia/tendencias
14.
Acta Med Indones ; 52(3): 199-205, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33020331

RESUMEN

Latar BelakangSebanyak 38.6% kasus kematian pasien COVID-19 di Indonesia terjadi di populasi lansia. Data mengenai profil klinis pasien rawat inap lansia dengan COVID-19 masih tidak ada. Padahal kelompok pasien ini adalah pasien risiko tinggi selama pandemi ini yang memerlukan perhatian lebih.MetodeStudi deskriptif ini menggunakan data lengkap pasien lansia dengan COVID-19 yang dirawat inap di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPN Cipto Mangunkusumo) dari April hingga akhir Agustus 2020. Data termasuk karakteristik klinis, gejala, komorbiditas, multimorbiditas dan luaran mortalitas pasien.HasilDi populasi pasien lansia (n=44), mayoritas berusia di antara 60-69 tahun (68%), berjenis kelamin laki-laki (66%), dan tidak memiliki riwayat kontak erat dengan pasien COVID-19 sebelumnya (86%). Gejala tersering ialah demam, batuk, dan sesak yang merupakan gejala khas COVID-19, sedangkan penyakit kronis tersering adalah diabetes melitus, hipertensi, dan keganasan. Multimorbiditas ditemukan hanya di 14% pasien lansia, dan para pasien tersebut bertahan hidup pasca infeksi virus SARS-CoV-2. Angka kematian pasien lansia rawat inap dengan COVID-19 di studi ini adalah 23%, dan 90% dari kasus kematian berjenis kelamin laki-laki.KesimpulanPasien laki-laki mendominasi kasus terkonfirmasi dan kasus kematian lansia dengan COVID-19. Gejala khas COVID-19 hanya ditemukan di sekitar setengah pasien penelitian. Pasien yang meninggal dunia memiliki persentase gejala khas lebih tinggi. Gejala tidak khas pun mungkin ditemukan di pasien lansia. Immunosenescence dan fungsi imunoregulasi jenis kelamin tertentu dihipotesiskan memiliki peran penting dalam menyebabkan kematian lansia di studi ini.Kata Kunci: Profil Klinis, Lansia, Pasien Geriatri, COVID-19, Indonesia  ABSTRACTBackgroundOlder people contributed to 38.6% of death cases related to COVID-19 in Indonesia. Data regarding clinical profile of hospitalised elderly with COVID-19 in Indonesia were still lacking. Older people are at-risk population in the pandemic, whom we should pay attention to.MethodsThis single centre descriptive study utilised complete data of elderly inpatients with COVID-19 in Indonesia's national general hospital from April to late August 2020. The data consisted of clinical characteristics, symptoms, comorbidities, multimorbidity, and mortality outcome.ResultsAmong elderly patients (n=44), a majority of patients were aged 60-69 years (68%), were male (66%), and had no history of close contact with COVID-19 patient (86%). The most common symptoms were fever, cough and shortness of breath (classic symptoms of COVID-19), whereas the most common chronic diseases were diabetes mellitus, hypertension, and malignancy. Multimorbidity was only found in 14% of patients, all of whom remained alive following SARS-CoV-2 infection. The death rate among elderly inpatients with COVID-19 in this study was 23%, and male older adults contributed to 90% of death cases.ConclusionMale patients dominated both confirmed cases and death cases among elderly with COVID-19. Classic symptoms of COVID-19 were only found in about half of the study patients. Non-survivors had higher percentage of the classic symptoms of COVID-19 than survivors. Atypical COVID-19 presentations are possible in older adults. We postulated that immunosenescence and sex-specific immunoregulatory function play an important role in causing death in this study cohort. Keywords: Clinical Profile, Elderly, Geriatric Patient, COVID-19, Indonesia.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Hospitalización/estadística & datos numéricos , Hospitales Generales , Pacientes Internos/estadística & datos numéricos , Neumonía Viral/epidemiología , Anciano , Comorbilidad , Infecciones por Coronavirus/terapia , Femenino , Humanos , Indonesia/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/terapia , Distribución por Sexo , Factores Sexuales , Tasa de Supervivencia/tendencias
15.
Acta Med Indones ; 52(3): 246-254, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-33020335

RESUMEN

BACKGROUND: Coronavirus Disease 2019 is an emerging respiratory disease that is now a pandemic. Indonesia is experiencing a rapid surge of cases but the local data are scarce. METHODS: this is an analysis using data from the ongoing recapitulation of Epidemiological Surveillance (ES) by the Provincial Health Office of Jakarta from March 2nd to April 27th 2020. We evaluated demographic and clinical characteristics of all confirmed cases in association with death. RESULTS: of the 4,052 patients, 381 (9.4%) patients were deceased. Multivariable analysis showed that death was associated with older age (odds ratio [OR] 1.03; 95% confidence interval [CI] 1.02, 1.05, per year increase; p<0.001), dyspnea (OR 4.83; 95% CI 3.20, 7.29; p<0.001), pneumonia (OR 2.46; 95%CI 1.56, 3.88; p<0.001), and pre-existing hypertension (OR 1.86; 95% CI 1.24, 2.78; p=0.003). Death was highest in the week of April 6th 2020 and declined in the subsequent weeks, after a large-scale social restriction commenced. CONCLUSION: older age, dyspnea, pneumonia, and pre-existing hypertension were associated with death. Mortality was high, but may be reduced by lockdown.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Pandemias , Neumonía Viral/mortalidad , Medición de Riesgo/métodos , Adolescente , Adulto , Distribución por Edad , Anciano , Niño , Estudios Epidemiológicos , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Indonesia/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Distribución por Sexo , Tasa de Supervivencia/tendencias , Adulto Joven
17.
Epidemiol Psychiatr Sci ; 29: e175, 2020 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-33070799

RESUMEN

AIMS: Previous studies regarding associations between depressive symptoms and suicidality (suicidal ideation, plans and attempts) have usually employed a variable-centred approach, without considering the individual variance in time-varying changes of depressive symptoms. Through 10-year follow-up of a large cohort of Chinese adolescents exposed to the 2008 Wenchuan earthquake, this study examined whether individual variance in depressive symptoms during the early phases post-earthquake could generate different suicidality outcomes in young adulthood. METHODS: A total of 1357 Chinese adolescents exposed to the Wenchuan earthquake were surveyed on depressive symptoms and other variables at 6, 18 and 30 months post-earthquake. In total, 799 participants responded to the 10-year follow-up and completed an online survey covering suicidality and other variables. The analytic sample was 744 participants who had valid data on depressive symptoms and suicidality. Data were analysed using logistic regressions. RESULTS: Prevalence estimates of past-year suicidal ideation, suicide plans and suicide attempts measured at 10 years post-earthquake were found to be 10.8%, 7.3% and 3.0%, respectively. Five trajectories of depressive symptoms were classified: resistance (54.4%), chronicity (13.3%), recovery (10.4%), delayed dysfunction (12.0%) and relapsing/remitting (10.0%). After controlling for covariates, whole-sample regressions revealed only the relapsing/remitting depressive trajectory remained significantly predictive of suicidality. Moreover, males not females in the chronic group were more likely to have suicide plans. CONCLUSIONS: The findings highlight the importance of detecting disaster survivors with different trajectories of mental status and providing with them individualised and effective mental health services, to decrease their risk of suicidality in the future.


Asunto(s)
Grupo de Ascendencia Continental Asiática/psicología , Terremotos , Trastornos por Estrés Postraumático/psicología , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Adaptación Psicológica , Adolescente , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Estudios de Cohortes , Depresión/diagnóstico , Depresión/etnología , Depresión/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Prevalencia , Factores de Riesgo , Distribución por Sexo , Trastornos por Estrés Postraumático/etnología , Suicidio/psicología , Intento de Suicidio/psicología , Encuestas y Cuestionarios , Sobrevivientes
18.
Medicine (Baltimore) ; 99(43): e22686, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33120760

RESUMEN

The effect of the afternoon napping duration on the risk of depression has not been well established, particularly with regard to sex and age differences. The present study examines the association between afternoon napping duration and depression stratified by sex and age among Chinese adults aged 45 years or older.The 2011 to 2012 survey of the China Health and Retirement Longitudinal Study was utilized, including 5746 participants. We conducted logistic regression with the overall sample and subjects stratified by sex and age.Elderly men with short napping (<30 minutes) had lower odds of having depression symptoms compared with those with no napping group (OR = 0.66, 95% CI = 0.44-0.97). In addition, the finding indicated that middle-aged women with long napping (≥90 min) had a marginally significant difference than those in reference, which showed a negative effect on depression (OR = 0.72, 95% CI = 0.51-1.01).Our findings revealed that extended daytime napping duration can decrease the risk of depression status among middle and elderly people. Moreover, relevant promotion measures should be adopted, such as a suitable rest environment and regular napping habits. The potential mechanism should be clarified by a longitudinal survey to examine the specific causality.


Asunto(s)
Depresión/epidemiología , Sueño/fisiología , Factores de Edad , Anciano , Estudios de Casos y Controles , Causalidad , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Distribución por Sexo , Factores de Tiempo
19.
Mayo Clin Proc ; 95(10): 2110-2124, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33012342

RESUMEN

OBJECTIVE: To address the issue of limited national data on the prevalence and distribution of underlying conditions among COVID-19 deaths between sexes and across age groups. PATIENTS AND METHODS: All adult (≥18 years) deaths recorded in England and Wales (March 1, 2020, to May 12, 2020) were analyzed retrospectively. We compared the prevalence of underlying health conditions between COVID and non-COVID-related deaths during the COVID-19 pandemic and the age-standardized mortality rate (ASMR) of COVID-19 compared with other primary causes of death, stratified by sex and age group. RESULTS: Of 144,279 adult deaths recorded during the study period, 36,438 (25.3%) were confirmed COVID deaths. Women represented 43.2% (n=15,731) of COVID deaths compared with 51.9% (n=55,980) in non-COVID deaths. Overall, COVID deaths were younger than non-COVID deaths (82 vs 83 years). ASMR of COVID-19 was higher than all other common primary causes of death, across age groups and sexes, except for cancers in women between the ages of 30 and 79 years. A linear relationship was observed between ASMR and age among COVID-19 deaths, with persistently higher rates in men than women across all age groups. The most prevalent reported conditions were hypertension, dementia, chronic lung disease, and diabetes, and these were higher among COVID deaths. Pre-existing ischemic heart disease was similar in COVID (11.4%) and non-COVID (12%) deaths. CONCLUSION: In a nationwide analysis, COVID-19 infection was associated with higher age-standardized mortality than other primary causes of death, except cancer in women of select age groups. COVID-19 mortality was persistently higher in men and increased with advanced age.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Disparidades en Atención de Salud/estadística & datos numéricos , Mortalidad Hospitalaria/tendencias , Neumonía Viral/mortalidad , Adulto , Distribución por Edad , Factores de Edad , Anciano , Causas de Muerte , Inglaterra/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estudios Retrospectivos , Distribución por Sexo , Factores Socioeconómicos , Gales/epidemiología
20.
J Postgrad Med ; 66(4): 194-199, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33037169

RESUMEN

Objective: Vitamin D deficiency is widely prevalent worldwide. This has led to a significant surge in referrals for vitamin D assessment in recent years. The cost-effectiveness and rationalization of this practice is uncertain. This study aimed to evaluate the referral pattern for vitamin D testing from a tertiary center in southern India. Materials and Methods: This was a cross-sectional study done over a period of one year (2017). A total of 95,750 individuals, referred for vitamin D screening were included in this study. Details regarding referring departments and indications for referral were obtained from the computerized hospital information processing system (CHIPS). Results: The study population exhibited a female preponderance (54.1%) with mean (SD) age of 40.3 (18.5) years. Overall, 44% were found to have vitamin D deficiency. Most of the referrals were from nephrology (15.4%), neurology (10.1%), and orthopedics (9.1%). Nevertheless, dermatology, the staff-clinic, and hematology which contributed to 3.3%, 1.7%, and 1.7% of referrals, had a higher proportion of vitamin D deficiency of 59.1%, 57.7%, and 64.6%, respectively. Although the most common indications for referral were generalized body aches (20.5%) and degenerative bone disorders (20.1%), the proportion of subjects with vitamin D deficiency referred for these indications were 46.1% and 41.6%, respectively. In contrast, chronic steroid use that accounted for 3.3% of the referrals had 59.1% of subjects who were deficient in vitamin D. Conclusion: To ensure a rational approach to vitamin D testing, clinicians ought to use their discretion to screen those truly at risk for vitamin D deficiency on a case to case basis and avoid indiscriminate testing of the same.


Asunto(s)
Tamizaje Masivo/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricos , Deficiencia de Vitamina D/diagnóstico , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Análisis Costo-Beneficio , Estudios Transversales , Hospitales de Enseñanza , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Distribución por Sexo , Deficiencia de Vitamina D/epidemiología , Adulto Joven
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